What should you know about excessive hiccups and burping?

A hiccup is an involuntary spasm of the diaphragm followed by a brief closure of the vocal cords. Burping releases air from the stomach. Eating rapidly, fizzy drinks, a large meal, sudden temperature changes and swallowed air can encourage both. Acid reflux or gastritis may irritate the upper digestive tract and link the symptoms, but the combination does not identify one condition by itself.

Eat slowly, take smaller mouthfuls and avoid talking while chewing. Reduce fizzy drinks, chewing gum and habits that make you swallow air. Sip water and notice whether large meals, alcohol, spicy food or lying down soon after eating makes symptoms worse. Do not use frightening or forceful breath-holding tricks. A clinician or pharmacist can advise whether acid reflux medication is appropriate.

Seek urgent help if hiccups or burping occur with severe breathing difficulty, chest pain, fainting, confusion, repeated vomiting or inability to swallow. Arrange a medical appointment when hiccups persist, repeatedly interrupt sleep or meals, cause exhaustion, or accompany ongoing abdominal pain, heartburn or vomiting. A clinician may review medicines and examine the digestive and nervous systems.

Could reflux or gastritis be irritating my diaphragm or upper digestive tract? Are any of my medicines contributing? What symptom diary or examination would help decide whether treatment is needed?